This blog was created for Niles Animal Hospital & Bird Medical Center by Peter S. Sakas DVM in an effort to provide information & discussion about animal related issues. It may move into some eccentric directions on occasion if the mood strikes me as I get more comfortable in this form of communication. I am open to suggestions & comments about the blog. Also view our hospital website www.nilesanimalhospital.com or Facebook page Niles Animal Hospital and Bird Medical Center.

Monday, July 14, 2014

This is an article about the underreporting of Lyme disease in Northern California. But it is chock full of good information about the disease including the fact that 1 out of 10 cases are reported and also some tips on preventing the disease.

Lyme disease often overlooked in Northern California

Four
summers ago, Carole Flaherty was training for a long-distance hike
across the Teton Range of the Rocky Mountains. The retired landscape
contractor from Healdsburg was routinely walking 25 miles a day -- until
strange pains stopped her in her tracks.

Fatigue, abdominal
aches and a burning sensation on her right side left her bedridden on
and off for months. After a battery of blood tests and misdiagnoses,
she's now in treatment for Lyme disease.

Flaherty, 68, never
noticed a tick bite but suspects she was bitten in one of the open space
preserves in the hills above Palo Alto, where she often visited her
mother.

Her case is hardly unusual. In the West, where
Lyme disease is less common than in the Northeast and the Midwest,
primary care doctors and most residents may not even be aware that the
disease exists in their area. And the lack of awareness can delay
diagnosis -- a serious danger.

Though a short course of
antibiotics cures most patients at early stages, later on the disease
becomes far more difficult to identify and treat and can lead to chronic
fatigue, muscle and joint pain, and neurological problems.

The
complexity of Lyme disease diagnosis, along with strict federal
reporting guidelines, makes under-reporting of the disease inevitable.
In August 2013, the federal Centers for Disease Control and Prevention
announced that the centers' own estimates, based on surveys of the
public, medical claims and laboratory test results, suggest that only 1
in 10 cases of Lyme disease are reported nationwide -- 30,000 reported
cases compared with 300,000 actual cases.

"For any disease with
more of a clinical diagnosis, the reporting is not going to be as good
as a disease for which there's a single laboratory test," such as HIV or
measles, said George Rutherford, an epidemiologist at UC San Francisco.

In
2012, the most recent year for which data are available, there were 66
confirmed cases of Lyme disease in California. And in some parts of
Northern California, especially in coastal redwood forests, the
prevalence of Lyme disease is higher than the statewide average.

The
disease is caused by spiral-shaped bacteria called Borrelia burgdorferi
and is transmitted to humans by ticks -- on the West Coast, the Western
black-legged tick. Nymphal ticks, more likely to be infected than
adults, are active from March to August in Northern California. Infected
ticks have been found in 42 of the state's 58 counties.

Because
nymphal ticks are about the size of a poppy seed, tick bites often go
unnoticed. Most people develop a characteristic bull's-eye rash within a
week or two of infection, but a substantial proportion do not. Other
signs of Lyme disease may not appear until later; the most common are
flu-like symptoms such as fever, fatigue and muscle aches.

Standard
tests for Lyme disease are designed to detect whether a patient's blood
contains antibodies against Borrelia burgdorferi. Yet immune responses
vary among patients, and the presence of antibodies doesn't necessarily
indicate an active infection.

Paul Mead, chief of epidemiology and
surveillance for the CDC's Lyme disease program, said under-reporting
occurs simply because some people never seek medical care, and many
physicians do not report cases. The CDC's under-reporting studies serve
as confirmation of recent increases in reported cases, Mead said. Public
health officials in Marin, Santa Cruz, Alameda and Mendocino counties
agreed that not everyone diagnosed with Lyme disease is counted as a
confirmed case.

But public health surveillance data can lead to a misconception that Lyme is virtually nonexistent in California.
Dr.
Raphael Stricker, a San Francisco physician who treats difficult Lyme
cases, thinks the reporting system does a disservice to people who are
infected with Lyme. "When patients fail that system, they're told,
'There's only 100 cases (per year in California). How could it be Lyme
disease?'" Stricker said. "And so they get misled and they don't get
diagnosed, and they get sicker and sicker."

Finding common ground
on any aspect of Lyme disease can be difficult, as the disease is
notoriously controversial. Some physicians adhere strictly to CDC
guidelines in making diagnoses, while others may rely on different types
of lab tests or interpret the tests more broadly. The very existence of
chronic Lyme disease is also debated, as is the treatment of chronic
cases with long-term antibiotics.

Gil Chavez, deputy director of
the Center for Infectious Diseases at the California Department of
Public Health, wrote in an email: "The important thing to remember is
that surveillance data is still very good to look at trends over time,
populations at risk, and to guide prevention efforts. More importantly,
we need to remind people that Lyme disease can be prevented."

Prevention
may be the only area of consensus on this controversial disease.
Fortunately, in California the risk of Lyme is concentrated in public
parks and other wooded areas -- unlike the Northeast, where many
infected ticks lurk in suburban backyards. So simple preventive
measures, such as using insect repellents and wearing pants and long
sleeves when hiking, can go a long way.

But that's little
consolation to the Lyme victims who are left with lingering symptoms
that keep them from working and living active lives.

Still, other patients make great strides.

Flaherty, the hiker from Healdsburg, says antibiotic treatments have aided her steady recovery.
Now able to walk six miles in a day, she once again dreams of walking across the Tetons.

Lyme disease prevention tips

Wear long pants and long-sleeved shirts. Light-colored clothing makes ticks easier to spot.Use insect repellents that contain 20 to 30 percent DEET.When hiking, stay in the middle of the trail. Avoid brush and grassy areas.Check yourself and your pets for ticks after spending time outdoors. Shower and wash clothes as soon as possible.

If
you find a tick, remove it carefully with fine-pointed tweezers; a tick
must be attached for at least a day to transmit Lyme disease. Save the
tick for identification.

Family Says it Wasn't Notified of Contagious Parakeets

PetSmart removes parakeets from all stores due to bacterial disease

PetSmart is alerting its customers
about a bacterial disease found in parakeets at its stores that can be
transmitted to humans, but one suburban Chicago family says their
warning came too late.

The store has confirmed several cases
of psittacosis, also known as parrot flu. When the bacterial infection
is transferred to humans -- in some cases through the bird's droppings
-- victims may develop cold or flu-like symptoms similar to a
respiratory illness usually within one to two weeks after exposure to an
infected bird.

The retailer says the infected birds
have been traced to a single supplier and are asking anyone who
purchased a parakeet from one of their stores between March 12 and May
20 to check their bird for illness.

The birds have been pulled from more than 500 of the retailer's stores.

New Lenox resident Wendi O'Brien
bought a parakeet at an Orland Hills PetSmart in April. She learned
about the sick birds after visiting the store to buy another on Tuesday
night, and went she got home, her daughter discovered their pet was
dead.

"The parakeet was chirping before we
left. We had dinner at grandma's and we got home 9 o'clock and she
started crying and brought the bird," O'Brien said.

O'Brien is upset because she says the
store didn't notify them about the problem with the parakeets, and her
bird had been flying around the house and exposed to elderly people and children at a birthday and graduation party.

"I am a perks member, so I should
have gotten that email," O'Brien said. "I would've taken more
precautions. I would've taken the bird back, had him quarantined. I
wouldn't have let our 8-year-old daughter clean his cage."

But now O'Brien says she's worried because she and two other family members have been suffering from respiratory problems.

"I just wish they were more
proactive prior to so that so I could've avoided this so I didn't need
to have this health scare," O'Brien said.

PetSmart is encouraging anyone with a
dead or sick bird to call the store so they can take it to an avian
veterinarian for testing.

Birds with psittacosis may appear to
be drowsy or depressed, eat poorly and have runny eyes and noses. They
may also sneeze, cough, have ruffled feathers or shiver. The bird's
droppings will often be watery.

Humans showing symptoms are urged to see a physician.

PetSmart officials say 16 cases of psittacosis have been confirmed at its stores across the country.